激动剂方案和拮抗剂方案对波塞冬组1人群的疗效分析
Efficacy Analysis of Gonadotropin-Releasing Hormone Agonist Protocol and Gonadotropin-Releasing Hormone Antagonist Protocol in POSEIDON Group 1
顾小铃 1陈艳男 1王青欣 1王迪 1王霞1
作者信息
- 1. 南通大学附属医院生殖医学中心,江苏 南通 226001
- 折叠
摘要
目的:评估促性腺激素释放激素激动剂(GnRH-a)方案和促性腺激素释放激素拮抗剂(GnRH-ant)方案在波塞冬(POSEIDON)组1 人群中的疗效.方法:回顾性分析2019 年1 月至2020年12 月在南通大学附属医院生殖医学中心行辅助生殖助孕的POSEIDON组 1 患者 399 例.采用1 ∶ 1 倾向性评分匹配(PSM)筛选具有相似基线特征的队列,比较GnRH-a方案组和GnRH-ant方案组患者的基线资料、临床及实验室指标和临床结局.结果:①100 例行GnRH-a方案的患者和100 例行GnRH-ant方案的患者形成匹配.②GnRH-a方案组的促性腺激素(Gn)使用总量和Gn总使用时间均高于GnRH-ant方案组(P<0.001,P =0.048),绒促性素(HCG)注射日的激素水平(黄体生成素、雌二醇、孕酮)均低于GnRH-ant方案组(P<0.001,P =0.011,P<0.001),两组间卵泡数差异无统计学意义(P>0.05);GnRH-a方案组获卵数、成熟卵子数、正常受精数、优质胚胎数和可利用胚胎数均低于GnRH-ant方案组(P<0.01).③GnRH-a方案组的到达活产时间(TTLB)高于GnRH-ant方案组(P =0.005),累积活产率(CLBR)低于GnRH-ant方案组(P =0.048),两组间移植次数(P = 0.536)、累积妊娠率(P =0.084)无统计学差异.④GnRH-a方案组到达活产的经济花费高于GnRH-ant方案组(P =0.02).结论:与GnRH-a方案相比,GnRH-ant方案可改善POSEIDON组1 患者的单次促排卵周期的CLBR,并可缩短患者TTLB,降低患者的治疗成本,是 POSEIDON 组 1 患者的优选方案.
Abstract
Objective:To evaluate the effect of gonadotropin-releasing hormone agonist(GnRH-a)protocol and gonadotropin-releasing hormone antagonist(GnRH-ant)protocol in POSEIDON group 1.Methods:From January 2019 to December 2020,399 patients in POSEIDON group 1 who underwent assisted reproductive technology in the Center of Reproductive Medicine,Affiliated Hospital of Nantong University were retrospectively analyzed.Cohorts with similar baseline characteristics were screened by 1 ∶1 propensity score matching(PSM),and base-line data,clinical and laboratory parameters,and clinical outcomes were compared between GnRH-a and Gn-RH-ant groups.Results:①100 patients from GnRH-a group and 100 patients from GnRH-ant group were matched.②The total dose and total use time of gonadotropin(Gn)in GnRH-a group were higher than those in GnRH-ant group(P<0.001,P =0.048),and the hormone levels of luteinizing hormone,estradiol and progester-one on the day of HCG injection were lower than those in GnRH-ant group(P<0.001,P =0.011,P<0.001).There was no statistical difference in the number of follicles between the two groups(P>0.05),the number of oocytes retrieved,mature oocytes,normal fertilized oocytes,high-quality embryos and available embryos were lower in GnRH-a group than those in GnRH-ant group(P<0.01).③In GnRH-a group,the time to live birth(TTLB)was higher than GnRH-ant group(P =0.005),and the cumulative live birth rate(CLBR)was lower than GnRH-ant group(P =0.048),and there was no statistical difference in the number of transplants(P =0.536)and cumulative pregnancy rates(P =0.084)between the two groups.④The economic cost to live birth of GnRH-a group was higher than that of GnRH-ant group(P =0.02).Conclusions:Compared with GnRH-a group,Gn-RH-ant group could improve the cumulative live birth rate of a single ovulation induction cycle in patients in PO-SEIDON group 1,shorten the time to live birth and reduce the treatment cost of patients,and was the preferred protocol for patients in POSEIDON group 1.
关键词
累积活产率/累积妊娠率/促性腺激素释放激素激动剂/促性腺激素释放激素拮抗剂/波塞冬标准Key words
Cumulative live birth rate/Cumulative pregnancy rate/GnRH agonist/GnRH antagonist/POSEI-DON criteria引用本文复制引用
基金项目
江苏省卫生健康委科研项目(Z2022069)
南通市基础研究和民生科技计划(JCZ21008)
南通市基础研究和民生科技计划(MSZ2022051)
南通大学附属医院多中心临床研究项目(LCYJ-B05)
出版年
2023
国家科技期刊平台
NSTL
万方数据